Organization
TRINITY CARE HOME OF MARIETTA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BERTONY BORNELUS BSW (ADMINSTRATOR)
(850) 766-5208
Entity
Organization
Contact information
Practice address
4150 LOWER ROSWELL RD, MARIETTA, GA 30068-4065
(770) 675-3117
Mailing address
4150 LOWER ROSWELL RD, MARIETTA, GA 30068-4065
(770) 675-3117
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
033013151
GA
Other
Enumeration date
03/01/2011
Last updated
03/01/2011
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